Provider Demographics
NPI:1144439860
Name:FLORIDA FOOT & ANKLE, LLC
Entity type:Organization
Organization Name:FLORIDA FOOT & ANKLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPROHA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:772-334-5377
Mailing Address - Street 1:3114 NE LOQUAT LN
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-5088
Mailing Address - Country:US
Mailing Address - Phone:772-334-5377
Mailing Address - Fax:
Practice Address - Street 1:3114 NE LOQUAT LN
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-5088
Practice Address - Country:US
Practice Address - Phone:772-334-5377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2736213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty